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Initial Consult – Part 1

What happens when you get sick and your doctor refers you to a specialist? Sometimes you feel like you’re the ball in a pinball machine, bouncing this way, then that. “Go here for this test, there for that test, then see this doctor who will send you somewhere else for more tests. And here’s a referral to another doctor who will want more tests.”

It’s frustrating! If it will help you to know what to expect when you’re referred to a rheumatologist, read on…

A rheumatologist will schedule 1-1/2 to 4 hours for your initial appointment – ask when you make your appointment how long you should expect it to take. Get a babysitter, if you have children. This is too long an appointment for your kids to have to be at the doctor’s office with you.

Paperwork
When there’s a lengthy waiting period between your PCP’s referral and your initial appointment with the rheumy, you can request that the office mail the paperwork to you. You’ll be happy to not have to rush through it in the waiting room. (Tip: If you take the extra time to type your answers on the paperwork, the doctor’s front-office staff will be thrilled to not have to try to decipher your penmanship.)

A rheumatologist needs tons of information to make a diagnosis – that’s probably true of any doctor. If you’ve never compiled a detailed medical history, now is the time. Once you’ve done it, you’ll never have to search for the information again. It’s worth taking the time to do it right. It took me days to gather all my information – I even wrote to aunts, uncles, and cousins for the big picture (and learned that there is a history of a few genetically-linked diseases in my family, but nobody had been telling anyone else about their doctor’s appointments).

I’m on my second rheumatologists. There’s very little that they didn’t both ask about, and based what others have indicated, it appears that other rheumies want similar information:

Basic InfoName, address, date of birth, and insurance information are obviously required. The RD will also need to know who referred you (not just because doctors get paid more for a consultation than for patients who decide on their own who to see). I highly recommend including your referring doctor’s complete name and address. If you say “Dr. Doe” your records might end up at any Dr. Doe’s office. If you say, “Dr. John A. Doe, Greatest PCP Clinic, 1234 Main Street, MyTown” there’s more chance of your referring doctor actually receiving a report.

System Review
This means that the doctor looks at how all the systems in your body are working: eyes, ears, nose, mouth, throat, neck, stomach and intestines, blood, kidneys and bladder, heart and lungs, muscles/joints/bones, skin and hair, nervous system, general…

Knowing the background that the doctor will ask about should help you be prepared to complete the lengthy paperwork required for your first appointment with a rheumatologist. This post was getting too long, so the physical exam is covered in my next post.